POS1135 METABOLIC OSTEOARTHRITIS: THE ROLE OF THE NUMBER OF COMPONENTS OF METABOLIC SYNDROME AND EXPRESSION OF CARTILAGE TISSUE DESTRUCTION GENES.
Authors: E. Strebkova, E. Taskina, N. Kashevarova, E. Sharapova, D. Kusevich, L. Alekseeva, A. Lila
Journal: Annals of the Rheumatic Diseases (2022)

Background Osteoarthritis (OA) associated with metabolic syndrome (MS) or its components is considered as the metabolic phenotype of OA. It is well known that obesity and other components of MS affect the clinical picture, course and progression of OA. The cumulative effect of metabolic disorders has an effect on the course and outcomes of OA. The study of molecular genetic relationships between the expression of cartilage tissue destruction genes and metabolic OA is one of the little-studied and relevant directions in rheumatology. Objectives To determine the role of MS component count and gene expression associated with cartilage tissue destruction in metabolic OA. Methods The study included women (n = 117) 45-75 y.o with knee OA (according by ACR criteria) I-III X-ray stage by Kellgren-Lawrence with different numbers of MS components. The duration of the study was 2 years. The clinic conducted visits 1 times a year. At each visit, anthropometric patient scores, articular status, VAS for knee pain, WOMAC and comorbidities were recorded. Patients underwent a laboratory examination (biochemical blood examination: glucose, total cholesterol, LDL, HDL, TG, isolation of blood RNA to determine the level of expression of cell proliferation genes - m-TOR and cartilage destruction - cathepsin K), instrumental examination (X-ray of knee joints) 1 once a year. Results All patients with knee OA included in the study (n = 117) showed an abdominal type of obesity (waist circumference &gt; 80 cm in women), which is the main criterion for MS. With frequency analysis in 5.5% of patients, 1 component of MS was detected, in 13.5% - 2 components of MS, in 70.2% - 3 components of MS, in 10.8% - 4 components of MS. Median (Me, 25%; 75% percentile) duration of knee OA disease was greater in patients with 2 or more MS components and was 7.3 years (6.0-8.0) compared to patients with 1 MS component, in whom the duration of OA was 5.4 years (2.0-11.0), p &lt; 0.05. Spearman correlation analysis showed significant relationships between MS component count and OA duration, age, BMI, VAS for knee pain, WOMAC (Table 1). Table 1. Analysis of the relationship between the number of MS components and OA by Spearman. Parameters Number of MS components р Age r=0,57 &lt;0,05 Duration of knee OA r=0,56 &lt;0,05 X-ray stage by Kellgren-Lawrence of knee OA r=0,24 &lt;0,05 BMI r=0,48 &lt;0,05 VAS for knee pain r=0,36 &lt;0,05 WOMAC pain r=0,47 &lt;0,05 WOMAC stiffness r=0,42 &lt;0,05 WOMAC functional insufficiency r=0,47 &lt;0,05 Total WOMAC r=0,46 &lt;0,05 Patients showed high expression rates of m-TOR cell proliferation regulator (11.08 (4.27-15.5)) and cathepsin K articular cartilage destruction (9.34 (3.66-12.5)). In analysis of Spearman correlations of cell metabolism gene expression with clinical manifestations of OA and MS components, direct positive correlations with VAS for knee pain were found (p &lt; 0.001, r = 0.95), body weight (p &lt; 0.001, r = 0.92), the number of MS components (p &lt; 0.001, r = 0.78) and WOMAC pain (p &lt; 0.001, r = 0.76). Conclusion In our work, it has been demonstrated that 3 or more components of MS in patients with knee OA are observed at pronounced X-ray stages of OA with longer disease duration and a long history of obesity. There are positive correlations between the number of MS components and the clinical course of OA, X-ray severity of OA, hyperexpression of cell proliferation and cartilage destruction genes. Disclosure of Interests None declared